no definitive tests; diagnosis is primarily based on clinical manifestations, history and presence of multiple lesions (MRI/CSF analysis). Based on subjective and objective assessment. Visual test to evoke response

Reassurance/permission related to alternate sexual expression

Include spouse/partner as much as possible

Refer to sex therapist as appropriate

ID effects of role changes on family processes

Assist families to implement normalizing strategies for their situation

Assist family to use existing support mechanisms

Design schedules of patient home care activities that minimize disruption of family routines

Facilitate communication of feelings

Provide assistance in meeting basic needs of family

Teach so families can make informed decisions about care

9

What is parkinson's?

degeneration of dopamine-producing neurons; disrupts the normal balance between dopamine and acetylcholine in the basal ganglia. Dopamine is the neurotransmitter essential for normal functioning of the extrapyramidal motor system, including control of posture, support and voluntary movement. Symptoms of PD don't occur until 80% of neurons are lost

MAOIs: block breakdown of acetylcholine (increases dopamine)

Assess RESPIRATORY SYSTEM

Safety - neuromuscular assessment/poor coordination

Experimental therapy: transplantation of fetal neural tissue into basal ganglia of the brain

13

What is Alzheimer's?

Chronic, progressive degenerative disease of the brain characterized by cognitive impairment. Tangles/plaques in the brain - s/sx can progress over years (mild, moderate, severe). Causes: neurodegenerative, vascular. Diagnosis made after other causes of delirium/dementia have been eliminated